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篇名 比較傷口敷料處置於壓瘡預防之成效
卷期 60:4
並列篇名 A Comparison of the Efficacy of Different Wound Dressing Management Techniques in Preventing Pressure Ulcers
作者 曹文昱羅淑芬哈鐵木爾李茹萍
頁次 065-075
關鍵字 加護病房預防壓瘡親水性敷料泡棉敷intensive care unitpreventionpressure ulcerhydrocolloid dressingfoam dressingMEDLINEScopusTSCI
出刊日期 201308
DOI 10.6224/JN.60.4.65

中文摘要

背景 傷口護理之高科技敷料於國内外臨床上廣為使用,但被用於預防壓瘡之成效,並無實證探討。
目的 探討常規翻身護理處置與合併使用親水性敷料或泡棉敷料後,對預防尾薦骨壓瘡發生之成效。
方法 採類實驗設計及方便取樣方式,以花蓮某醫院外科加護病患共90位為樣本,隨機分派至「常規翻身
組」、「常規翻身合併使用親水性敷料組」或「常規翻身合併使用泡棉敷料組」。以Braden scale作為評 估壓瘡風險工具,並採歐洲壓瘡諮詢委員會最新壓瘡分級標準用以每日檢視皮膚。資料分析以f檢 定、ANOVA及曼一惠特尼U檢定。
結果 「合併使用泡棉敷料組」之病人並未發生任何壓瘡。餘發生壓瘡比率以「常規翻身組」最高,其次為
「合併使用親水性敷料組」,發生壓瘡等級以一、二級居多;然此兩組在發生壓瘡的時間上未達顯著 差異。檢視「有發生壓瘡組」與「無發生壓瘡組」之間,其性別、高血壓史及身體質量指數變項均達 顯著差異< .05)。
結論/建議對於臨床上高危險群病患’除了應採落實的更換姿位以及檢視皮膚之外’可視情況介入親水性
實務應用敷料或泡棉敷料以預防尾薦骨壓瘡。

英文摘要

Background: Although high-technology wound dressings are widely used in clinical care worldwide, no evidence or discussions have been published regarding the efficacy of these dressings in preventing pressure ulcers.
Purpose: This study presents a repositioning of routine management combined with hydrocolloid dressing or foam dressing for pressure ulcer prevention.
Method: We used a quasi-experimental design and recruited a convenience sample of 90 from a surgical intensive care unit (SICU) at a medical center in Hualien County, Taiwan. Participants were allocated randomly to one of three groups: repositioning of routine management, hydrocolloid dressing, and foam dressing. Study instruments included a pressure ulcer risk table (Braden scale) and the pressure ulcer classification system of the European Pressure Ulcer Advisory Panel. An independent sample t-test, ANOVA, and Mann-Whitney U test were used to verify research hypotheses.
Results: The repositioning of routine management group had the highest pressure ulcer incidence rate, followed by the hydrocolloid-dressing group. The foam-dressing group recorded no pressure ulcers. Pressure ulcer occurrence grades were primarily level 1 and 2. There was no significance difference in pressure ulcer occurrence time between the repositioning of routine-management group and the hydrocolloid-dressing group. Finally, there were significant differences (p< .05) among gender, hypertension history, and BMI regardless of pressure ulcer incidences.
Conclusion: It is recommended that patients in high-risk groups in clinical settings adopt strategies including repositioning and regular visual skin examinations. Also, hydrocolloid or foam dressings may be used as appropriate to prevent sacral pressure ulcers.

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